FORM

Oklahoma Tax Commission

Small Business Capital Company
527Revised 2000

Information Report
FOR THE CALENDAR YEAR ENDING .
Identification Number Corporation Partnership LLC
Name of Small Business Capital Company
Address
City State Zip

Complete The Applicable Sections For Investments Made During This Calendar Year.
Attach Additional Schedules If Necessary.

A) Entities investing in the Small Business Capital Company.

IDENTIFICATION DATE AMOUNT
INVESTOR’S NAME ADDRESS NUMBER INVESTED INVESTED

1) / /

2) / /

3) / /

4) / /

5) / /

6) / /

7) / /

8) / /

B) Entities Investing In Oklahoma Small Business Ventures In Conjunction With The Small Business Capital Company.
IDENTIFICATION BUSINESS IDENTIFICATION DATE OF AMOUNT
INVESTOR’S NAME NUMBER INVESTED IN NUMBER INVESTMENT INVESTED

1) / /

2) / /

3) / /

4) / /
C) Oklahoma Small Business Ventures In Which Investments Were Made By The Small Business Capital Company.
IDENTIFICATION TYPE OF DATE OF AMOUNT
NAME OF BUSINESS INVESTED IN NUMBER BUSINESS INVESTMENT INVESTED

1) / /

2) / /

3) / /
4) / /

Under penalties of perjury, I declare that I have examined this return, including accompanying statements, and to the best of my know-
ledge and belief it is true, accurate and correct.

Officer, General Partner or Member Date

The Oklahoma Tax Commission is not required to give actual notice to taxpayer of changes in any state tax law.
 INSTRUCTIONS AND GUIDELINES FOR PREPARING
SMALL BUSINESS CAPITAL REPORTS
TITLE 68 SECTION 2357.60 - 2357.65 AND RULE 710:50-15-86
Reporting Requirements:
Each Small Business Capital Company shall file Form 527
with the Oklahoma Tax Commission by April 30th following
the year in which investments were made.
This report shall contain a list of all funds invested in, or in
conjunction with, the Small Business Capital Company that
may qualify for the tax credit allowed by this act. The
report shall state the amount of funds invested, the date of
the investment, the name and identification number of the
entity making the investment and the business in which the
investment was made.
This report shall also contain information regarding the
investments made by the Small Business Capital Com-
pany in Oklahoma Small Business Ventures. The report
shall state the name and identification number of the
business in which the investment was made, the type of
the business, the date of the investment and the amount of
the investment.
Additional Reporting Requirement:
Each qualified Small Business Capital Company shall also
make Form 527-A available to all investors in such com-
pany. This form shall show the name of the qualified Small
Business Capital Company, the name of the investor, the
date of the investment, the total amount of investments in,
or in conjunction with, the company made by such investor
and the amount of credit currently available. This form
shall be enclosed with the filed Oklahoma income tax
return of the taxpayer claiming the credit.
Definitions:
A qualified Small Business Capital Company can be a “C”
or subchapter “S” corporation as defined by the Internal
Revenue Code, incorporated pursuant to the laws of
Oklahoma; a limited liability company; or a registered
business partnership with a certificate of partnership filed
as required by law. The qualified Small Business Capital
Company must be organized to provide the direct invest-
ment of equity and near-equity funds to Oklahoma Small
Business Ventures. The principal place of business is
located within Oklahoma. The capitalization of the Small
Business Capital Company must be at least $1,000,000
and it can not invest more than 20% of its funds in any one
company.
An Oklahoma Small Business Venture can be any busi-
ness, incorporated or unincorporated, which has, or will
have, immediately after a loan or investment is made by
the Small Business Capital Company, 50% of its employ-
ees or assets in Oklahoma. Further, the business must
need financial assistance to start or expand such business
which provides, or intends to provide, goods or services.
The business venture must qualify as a small business as
defined by the federal Small Business Administration. The
Small Business Venture can not be primarily engaged in oil
and gas exploration; real estate development, sales or
rentals; wholesale or retail sales; farming; ranching;
banking; or lending or investing funds in other businesses.
However, businesses that provide or intend to provide
goods or services to the aforementioned businesses shall
not be considered primarily engaged in those activities.
This information return must be filed by April 30th.
Mail to: Oklahoma Tax Commission
Audit Division: Corporate Income Tax
P.O. Box 53403
Oklahoma City, OK 73152-3403